Objectives: To evaluate cervical regeneration at 6 months following excisional treatment for high-grade cervical intraepithelial neoplasia (CIN), and to investigate the effect of cone dimensions, age of patients and technique of excision on the efficacy of the regeneration process.

Objective: A vulvar squamous intraepithelial lesion is deemed to be a preceding lesion to vulvar cancer, especially in women aged under 40 years, holders of an acquired or idiopathic immunosuppression. Several treatments have been used to treat these lesions. One of the aesthetically acceptable therapeutic methods is the CO laser vaporization. Read More

Purpose: Uterine cervical conization is related to adverse pregnancy outcomes in subsequent pregnancies. To deal with this problem, we started conservative coin-shaped conization for reproductive-aged patients with cervical intraepithelial neoplasia (CIN). Here we report both the obstetrical and oncological impacts of this operation in comparison with the standard cone-shaped resection. Read More

Purpose: To characterize the clinical presentation and outcome of patients with vaginal intraepithelial neoplasia (VAIN).

Methods: Medical records of 65 women with VAIN treated between 2005 and 2012 at the colposcopy clinic of a German university hospital were retrospectively evaluated for VAIN grade, HPV status, VAIN localization, treatment method and relapse rate. Follow-up data were available for 53 patients (82 %). Read More

Risk of human papillomavirus (HPV) transmission during laser vaporisation of genital warts or loop electrode excision procedure is controversial. An oral rinse, a nasal swabs, history of HPV related diseases and data on HPV exposure were collected from 287 employees at departments of dermato-venerology and gynaecology in Denmark. A mucosal HPV type was found among 5. Read More

Aim: The aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia (VAIN) after hysterectomy in Chinese women and to identify factors affecting persistence/recurrence.

Material And Methods: Twenty-eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Read More

Purpose: The aim of our study was to evaluate the risk factors for treatment failure of CO2 laser vaporization in patients with cervical intraepithelial neoplasia 2 (CIN2).

Methods: Medical records of patients who received either shallow or deep CO2 laser vaporization with biopsy-proven CIN2 during March 2007 to April 2011 were reviewed retrospectively. After laser vaporization, liquid-based cytology and human papilloma virus (HPV) DNA testing were checked in every follow-up visit. Read More

Authors:

Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.

Introduction: To reduce the risk of local infections after surgical treatments for HPV infected cervical lesions, the post-operative regimen is generally based on the use of vaginal antimicrobial agents.

Aim: The efficacy and safety of polyhexamethylene biguanide-based vaginal suppositories was compared to a similar chlorhexidine-based treatment, in the post recovery regimen after surgical treatment of cervical lesions.

Aim: The best treatment option for cervical intraepithelial neoplasia 2 (CIN2) is controversial and there is a lack of studies in value-based medicine. This multicenter comparative study was undertaken to evaluate the effectiveness, cost-effectives and quality of life (QOL) of loop electrosurgical excision procedure (LEEP) and CO(2) laser vaporization for the treatment of CIN2.

Material And Methods: A database of LEEP and laser vaporizations performed at three research centers was created. Read More

Authors:

Department of Gynaecology, Perinatology and Childhealth, University Sapienza, Rome, Italy.

Aims: To evaluate the effectiveness of laser CO2 vaporization in high-grade cervical intraepithelial neoplasias and to assess the diagnostic reliability of cytology, colposcopy, microbiology and HPV tests in predicting recurrence in a long-term outcome.

Methods: Forty-four patients affectd by high-grade cervical intraepithelial neoplasia (HG-CIN) were submitted to laser CO2 vaporization and followed-up a minimum of five years. Vaginal smears for microbiological examination were detected. Read More

Authors:

First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.

Objective: To evaluate relapsing cervical intraepithelial neoplasia (CIN) and establish the criteria of recurrence to assess management by laser CO2.

Study Design: Patients with histologically proved CIN after a primary conservative approach were the study population. Disease relapse was considered as residual or recurrent if diagnosed within or after the first year of follow-up. Read More

Aim: To evaluate the recurrence rate of high-grade squamous intraepithelial lesions in postmenopausal women previously submitted to laser CO2 conization and the role of persistent oncogenic HPV types.

Patients And Methods: Fifty-five patients with a cytological diagnosis of high-grade squamous intraepithelial lesions were triaged with a standard colposcopy. Hormonal replacement therapy was considered as significative in influencing cervical trophism. Read More

Authors:

Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.

Aim: To investigate the therapeutic efficacy of cylindrical or cone-shaped excision performed by laser CO2 in the conservative management of persistent-recurrent high-grade cervical intraepithelial neoplasia (HG-CIN) in women of fertile age.

Patients And Methods: Ninety-four premenopausal patients with persistent-recurrent HG-CIN had undergone re-conization or cylindrical excision according to the time of reappearance of the disease. The length of the procedures, intra- and postoperative complications, height of the excised specimens, final histological findings and follow-up data were retrospectively evaluated. Read More

Objective: To evaluate the effect of oral contraceptive use on the recurrence rate of human papillomavirus (HPV) lesions and cervical intraepithelial neoplasia (CIN) following ablative or excisional procedures in a long-term follow-up.

Method: The study was conducted with 650 oral contraceptive users presenting with HPV lesions and/or CIN, and 670 women who had these lesions but did not use oral contraceptives acted as controls. The participants underwent cytologic evaluations, colposcopy, and direct biopsy, followed by either ablative treatment by laser carbon dioxide vaporization or excision by a loop electrosurgical excision procedure or cold knife conization. Read More

Authors:

Department of Gynecology, Perinatology and Human Reproduction, School of Medicine, University of Florence, Via Morgagni 85, 50134 Florence, Italy.

The purpose of this study is to evaluate the feasibility, safety, and potential therapeutic benefit of laser CO(2) conization of the cervix for in situ and minimally invasive carcinoma diagnosed during pregnancy. Twenty-six pregnant patients with biopsy-proven carcinoma in situ/cervical intraepithelial neoplasia III but colposcopically suspicious for invasion underwent laser CO(2) conization during the 18th week of gestation in an outpatient setting under local anesthesia. No major intraoperative or postoperative complications occurred, and cervical cerclage was not required in any case. Read More

Authors:

Department of Obstetrics and Gynecology, Yale University School of Medicine, Section of Gynecologic Oncology, New Haven, CT, USA.

Objective: To evaluate the effectiveness of CO(2) laser ablation of vaginal intraepithelial neoplasia (VAIN) and to define prognostic factors.

Study Design: Medical records of 24 patients with VAIN II or III, treated by CO(2) laser ablation from 1990 to 1998 were reviewed. The grade, location, and focality of the lesions, the age, follow-up period and menopausal status of the patients, the power and duration of laser ablation, the presence of concurrent cervical or vulvar neoplasia or previous hysterectomy were evaluated as possible prognostic factors. Read More

Methods: A retrospective evaluation. Case collection: A total of 77 women, 47 outpatients and 30 inpatients with endocervical CIN3 or CIN2, were treated by carbon dioxide (CO2) laser between 1993 and 1995. Read More

Authors:

Department of Obstetrics and Gynecology, Aristoteleion University of Thessalonika, Greece.

Purpose: The aim of this study was to determine the rates of incomplete excision of cervical intraepithelial neoplasia (CIN) III after carbon dioxide laser conization, and the risk of reappearance of CIN depending on the excision margins.

Methods: A total of 153 women who underwent carbon dioxide laser conization for CIN III between 1988 and 1998 at our hospitals were eligible for inclusion in the study and their notes were retrospectively studied.

Authors:

Department of Obstetrics and Gynecology, Umeâ University Hospital, Umeå, Sweden.

Objective: We wished to evaluate the effectiveness of treatment of cervical dysplasia by laser conization in relation to persistence of human papillomavirus after treatment.

Study Design: Of 203 women referred to colposcopy because of an abnormal Papanicolaou smear, 149 women could be followed up for 3 years. A total of 108 women were treated by carbon dioxide laser excision, 4 women were treated by carbon dioxide laser evaporation, and 37 women were merely followed up. Read More

Authors:

Objective: A retrospective study with the aim of analysing efficiency, anatomical and functional consequences of a conservative methodology for the treatment of cervical intra-epithelial neoplasias (CIN) using carbon dioxide laser.

Materials And Method: Two hundred and thirty patients were treated and studied with an average waiting period of 38 months. During the study new methodology allowed a cut in the pulse regimen with adjustments in high energy levels. Read More

We report a case of sigmoid perforation, peritonitis, and adult respiratory distress syndrome after a loop excision procedure for carcinoma in situ of the cervix and dysplasia of the vagina. Treatment of vaginal dysplasia with loop excision is potentially dangerous. Safer methods of management include carbon dioxide laser, topical 5-fluorouracil, and fulguration. Read More

Authors:

Department of Obstetrics and Gynecology, Spedali Civili University of Brescia, Italy.

From October 1989 to June 1997, 1841 patients (pts) suffering from different diseases of the lower genital tract have been treated with CO2 laser surgery in our Institution: among them, 782 were affected by cervical intraepithelial neoplasia (CIN). All pts underwent CO2 laser procedure for CIN after adequate colposcopic evaluation of the entire lower genital tract, colposcopic guided biopsy of the lesion, adequate pre-surgical work-up for possible infectious and coagulation associated disease. In 736 (94. Read More

Authors:

Objective: To determine if carbon dioxide laser conization of the cervix is a risk factor for preterm delivery in subsequent gestations and to evaluate whether there is any relationship between cone height and duration of pregnancy.

Methods: Patients of fertile age who had carbon dioxide laser conization were followed for reproductive events. Cases were matched one-to-one with controls for known risk factors for preterm delivery. Read More

Authors:

Department of Obstetrics and Gynecology, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.

Objective: To assess the risk of residual and recurrent disease after carbon dioxide laser conization treatment for high-grade lesions of the cervix uteri, and thus to refine intervals for follow-up.

Methods: The study population comprised all women treated for cervical intraepithelial neoplasia grade II-III over a 10-year period (1983-1992). All women who resided within the county for the entire follow-up period were followed for residual or recurrent disease, verified histologically until the closure date of January 31, 1996. Read More

Authors:

Department of Obstetrics and Gynecology, University of Patras, Rio, Greece.

This study was undertaken to assess the effectiveness of CO2 laser (vaporization), 5-FU topical application and Interferon (IFN alpha-2a) parenterally in the therapy of penile intraepithelial neoplasia (PIN). From March 1986 to September 1991, 1,372 men, sexual partners of women with condylomata accuminata or flat or cervical intraepithelial neoplasia (CIN), were submitted to peoscopy, of 1,019 men who presented with various lesions caused by human papillomavirus (HPV)-confirmed histologically-208 were treated for PIN. The best treatment modalities irrespective of grade of lesion were found to be the combination of 5-FU plus CO2 laser vaporisation plus IFN alpha-2a (high dose) (96. Read More

Authors:

Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.

Background And Objective: Minimal conization with carbon dioxide laser (CO2) for safe diagnosis and treatment of cervical intraepithelial neoplasia (CIN) 1-3 has been utilized for 15 years. To evaluate the results of 15 years' follow-up.

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Authors:

Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.

Objective: To describe the outpatient procedure of minimal conization with free-hand guided high power density carbon dioxide laser for simultaneous diagnosis and treatment of CIN producing a one-piece tissue specimen for histological examination.

Material And Methods: 3100 non-pregnant patients with mild, moderate or severe dysplasia in pap smear, having colposcopically proved ectocervical lesions but without evidence of invasive carcinoma, or 85 pregnant patients with severe dysplasia in pap smear having extensive colposcopic signs of at least carcinoma in situ were admitted for this treatment. This outpatient procedure including cervical curettage is performed under local anesthesia to excise a one-piece 5 mm (during pregnancy 7 mm) deep minicone. Read More

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Authors:

Department of Obstetrics and Gynaecology, University of Lund, University Hospital, Sweden.

We routinely use the carbon dioxide laser miniconisation procedure for cervical interepithelial neoplasia I-III. A retrospective case control study was conducted in 1,485 miniconised women during 250 subsequent pregnancies (including three twin pregnancies). The analysis showed that the miniconised subjects had no significant pregnancy complications and the same preterm birth ratio (8. Read More

Authors:

Background: The advent of modern electrosurgical equipment has allowed for outpatient excisional procedures rather than ablative therapy for patients with high grade squamous intraepithelial lesions (HGSILs).

Methods: The advantages and disadvantages of the commonly used ablative and excisional techniques for treatment of HGSILs were reviewed.

Results: Electrofulguration or cryotherapy for HGSILs smaller than 2. Read More

Authors:

After treatment for cervical intraepithelial neoplasia (CIN) the follow-up of patients would be simplified if colposcopy could be safely omitted. A study of 50 patients was performed to determine the feasibility of such an approach. Cervical cytology, cervicography and colposcopy, with or without biopsy, was performed in each patient. Read More

Authors:

The CO2 laser proved to be a vital tool in the development of conservative therapy for the treatment of CIN in the 1980s. In conjunction with colposcopy, the laser has allowed many women to achieve the security of identified and treated CIN with the freedom to live their lives normally, including the achievement of pregnancies. The laser may be used either in the ablative (vaporization) or the cutting mode. Read More

Carbon dioxide laser conisation is a very reliable surgical technique for cervical intraepithelial dysplasia. As cervical morphology and function are better preserved than with other techniques, obstetrical morbidity should be lower in the often young and pauciparous women who undergo this procedure. In our study comparing the course of 71 pregnancies (55 children) in 54 operated women with that of 82 pregnancies (59 children) in these same women before conisation, the rates for complications at the beginning of pregnancy were similar (respectively, 14. Read More

Authors:

2nd Department of Obstetrics and Gynecology, University of Rome La Sapienza, Italy.

Between 1984 and 1992, the CO2 laser was used to treat 341 patients affected by CIN of various degrees. On the basis of specific indications these patients underwent vaporization or conization. Two hundred and twenty eight patients underwent vaporization of intraepithelial lesions, 221 (96. Read More

Authors:

The authors presented use of carbon dioxide laser in treatment of dysplasia of the uterine cervix in women with malreproduction. Between November 1991 and September 1993 in the Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań the CO2-laser vaporisation in 21 women was done. In 19 patients the healing was achieved. Read More

Authors:

We use two kinds of laser treatment, namely, laser vaporisation and laser excision conisation. Laser vaporisation is a widely used method of localised ablative treatment based on both histologically confirmed cervical intraepithelial neoplasia and clear colposcopic visualisation of the upper limit of the lesion. Laser excision conisation is performed, if cervical intraepithelial neoplasia reaches the endocervix, being out of colposcopic view, and the squamocolumnar junction is localised in the endocervical canal. Read More

Authors:

An study with 52 patients, was performed at the colposcopy Service, Hospital López Mateos, IMSS. The patients presented with an histological diagnosis of cervical in situ carcinoma. They were, previously, submitted to a colposcopic and cytological protocol study. Read More

Authors:

II Clinic of Obstetrics and Gynecology, University of Rome La Sapienza.

63 pts affected by CIN of various degrees were randomly divided into 3 groups in order to evaluate the pain experienced during laser vaporization of the lesion. All pts were premenopausal and ages ranged between 19 and 39 years. 21 pts received Naproxene Sodium (550 mg) 30 minutes before surgery; 21 pts received placebo and 21 pts received no drug. Read More

Authors:

A randomized controlled trial was carried out at colposcopy clinics in the Birmingham and Midland Hospital for Women, to determine the efficacy of laser vaporization in the management of cervical Human Papilloma Virus (HPV) infection occurring alone or in association with cervical intraepithelial neoplasia (CIN), and to study the natural history of these lesions. The subjects were 365 women referred for investigation of cytological abnormality who were found to have histological evidence of HPV infection alone or in association with CIN1 or CIN2 and were considered suitable for local destructive treatment. The intervention consisted of immediate treatment using a carbon dioxide laser or no treatment. Read More

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Authors:

Division of Obstetric and Gynecologic Pathology and Cytology, Sloane Hospital for Women, New York, NY 10032.

There has been an enormous change in outpatient-directed surgery for human papillomavirus-related lesions of the anogenital tract over the past 2 years. Concern that a small number of invasive cancers were being missed during evaluation and were being treated as precursors led many investigators to suggest excisional rather than ablative procedures for precursor management. The use of cold-knife or carbon dioxide laser excisions was recommend as the procedure of choice--particularly for high-grade cervical intraepithelial neoplasia lesions. Read More

Authors:

Aim And Objective: To evaluate the feasibility of CO2 laser excisional conization in patients with cervical intraepithelial neoplasia (CIN) in an outpatient setting under local anesthesia.

Design: A prospective study of women with cervical intraepithelial neoplasia over one year recording early and late complications, cure rate, and patients' compliance. The procedure was performed with a Coherent CO2 laser connected to the colposcope with a micromanipulator. Read More

Authors:

Over a 6-year period, 40 young women under 20 years of age with cervical intraepithelial neoplasia (CIN) grade I (58%) to grade III (10%) were treated by laser vaporisation or excisional conisation. This prevalence of CIN in young women (nearly 4% of laser-treated cases) underscores the need for detection of cervical abnormalities in all teenagers engaged in sexual relations. The colposcopically-guided carbon dioxide laser technique is the treatment of choice for vaporisation and conisation of intraepithelial lesions (extending to the periphery of the cervix in 20% of cases) and for vaporisation of associated condylomatous lesions of the cervix (75%), vagina (23%), vulva (48%) and/or anus (8%). Read More

Authors:

Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, R.O.C.

Preinvasive cervical carcinoma (PCC) is a disease entity of the uterine cervix resulting from carcinoma in situ and various degrees of dysplasia. These cases are conventionally treated by a total abdominal hysterectomy. Effective management that can preserve the uterus is more desirable than hysterectomy. Read More

Authors:

CO2 laser vaporisation is an effective method in the treatment of cervico-vaginal pre-invasive lesions. In a case-series of 334 patients no case of invasive neoplasia development were registered at longterm follow-up. The failure rate is comparable to those described with traditional surgical methods and are due to the particular topography of the disease. Read More

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